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Today’s look at Traditional Chinese Medicine (TCM) is going to delve deeper into the way that the practice is used to diagnose diseases. In fact pattern diagnosis (bian zheng) begins with an examination of the symptoms/signs of the “Eight Principles” (ba gang).

In an effort to make this appear a little more science-y you can find a number of attractive charts like this relating to Tradtional Chinese Medicine. This shows meridians in the arm and thumb.

While eight may be a lucky number in Chinese culture, these are a not so lucky expression of the figure and as with all things TCM they come in pairs based around the fundamental aspects of a disease: in particular heat/cold, ying/yang, repletion/vacuity and exterior/interior. With the most “clinically important” being heat/cold and repletion/vacuity. Yin/yang is considered to be the least fundamental aspect as it offers vague conclusions based on the other qualities discovered during diagnosis.

The Eight Principles of Pattern Discrimination in TCM

Exterior (biao) as you might expect this refers to physical expression of symptoms on the outside of the body – hair, skin and meridians. Thankfully your tongue is left alone as part of this diagnosis and it is supposed to represent an avoidance of cold, muscular pains, headaches, light fever and a “floating pulse”.

Interior (li) in this case the symptoms are expressed in the “zang fu” or basically anywhere that isn’t on the outside. The expressions don’t have a generalisation and are determined by the indiviudal zang or fu body that is affected.

Cold (han) once again avoidance of the cold comes up, and is coupled with “an absence of thirst” – both things that seem pretty normal to me, but wait a minute what’s up with your tongue? If it’s covered in white fur – you’ve collected the set.

Heat (re) not avoiding cold is the kick off, a sore “red” throat, rapid and floating pulse, and dry fur on your tongue.

Vacuity (xu) – vacuity can also be called a “deficiency” and this applies to either (or combinations of) qi, yin, yang or xue and the usual symptoms that go alongside these things. Deficiency in yin is known as vacuity-cold and for yang it’s vacuity-hot.

Repletion (shi) which is the opposite of vacuity and hence an “excess”. So it’s here you’ll find the six excesses and/or a pattern of stagnation in the xue, qi, yin or yang.

Yin and yang don’t really have symptoms of their own, and these are generally expressed by pairs of principles from the other six instead.

Once the patterns and principles have been identified the practitioner then usually classified the disease in more specific terms by one (or more) of the following:

  • The Meridians (jing luo bian zheng)
  • Qi (qi xue bian zheng)
  • Xue (qu xue bian zheng) – In case you hadn’t noticed that’s the same as the one for qi
  • Body Fluids (jin ye bian zheng)
  • Zang fu (zang fu bian zheng) or occasionally in terms of the five elements (wu xing biang zheng)

And if it doesn’t fit there there’s also three others for infectious and febrile diseases:

  • Six Channel System (liu jing bian zheng)
  • Four Division Pattern (wei qi ying zue bian zheng)
  • Three Burners Pattern (sanjiao bian zheng)

Causes of disease

Peculiarly for a system of medicine, TCM doesn’t really draw much of a line between cause and effect and often the pattern discrimination is considered to provide the information about the cause. However there are officially three categories of cause in TCM

Some more TCM Meridians this time for the whole body, looks convincing doesn't it? (Source: Wikipedia)

External – Including “Pestilential Qi” and the Six Excesses

Internal – The Seven Emotions/Affects (qi qing) – anger, sorrow, grief, fear, brooding, fright and err… joy. These are believed to mess with your zang fu and in particular the LIVER.

Everything Else – dietary problems (eating too much cold, spicy, sweet, fatty or raw food – or too much booze), sexual problems, trauma, parasites (chong) and fatigue.

So there we have it, you now have enough knowledge to diagnose conditions in terms of TCM – though we really don’t recommend you practice this at home. At least not until you’ve read the next part of the series regarding Traditional Chinese Medicine treatments and you draw your own conclusion on the efficacy of the options available to you. We’ll start tomorrow with Chinese Herbal Medicine.

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